Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties.
BACKGROUND
Psychotropic medications are widely prescribed, but how new classes of psychotropic medications have affected prescribing patterns has not been well documented.


OBJECTIVE
To examine changes between 1985 and 1994 (data from 1993 and 1994 were combined) in the prescribing patterns of psychotropic medications by office-based primary care physicians, psychiatrists, and other medical specialists.


METHODS
National estimates for the number of visits during which a physician prescribed a psychotropic medication based on the National Ambulatory Medical Care Surveys conducted in 1985, 1993, and 1994.


METHODS
Office-based physician practices in the United States.


METHODS
A systematically sampled group of office-based physicians.


METHODS
National estimates of visits that included a psychotropic medication.


RESULTS
The number of visits during which a psychotropic medication was prescribed increased from 32.73 million to 45.64 million; the proportion of such visits, as a proportion of all visits, increased from 5.1% to 6.5% (P< or =.01). Antianxiety or hypnotic drug visits, previously the largest category, decreased as a proportion of psychotropic drug visits (P< or =.01) and are now surpassed by antidepressant visits. Visits for depression increased from 10.99 million in 1988 to 20.43 million in 1993 and 1994 (P< or =.01). Stimulant drug visits increased from 0.57 million to 2.86 million (P< or =.01). Although visits for depression doubled for both primary care physicians and psychiatrists, the proportion of visits for depression during which an antidepressant was prescribed increased for psychiatrists but not for primary care physicians.


CONCLUSIONS
The patterns of psychotropic medication use in outpatient medical practice changed dramatically during the study period, especially in psychiatric practice.
Pincus
H A
HA
Office of Research, American Psychiatric Association, Washington, DC 20005, USA. hpincus@psych.org
Tanielian
T L
TL
Marcus
S C
SC
Olfson
M
M
Zarin
D A
DA
Thompson
J
J
Magno Zito
J
J
D003625:Data Collection; D003866:Depressive Disorder / Q000188:drug therapy; D004363:Drug Utilization / Q000639:trends*; D005194:Family Practice / Q000706:statistics & numerical data / Q000639:trends; D019538:Health Care Surveys; D006801:Humans; D008511:Medicine / Q000706:statistics & numerical data / Q000639:trends*; D009819:Office Visits / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011570:Psychiatry / Q000706:statistics & numerical data / Q000639:trends; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D013038:Specialization; D014481:United States / Q000453:epidemiology
D011619:Psychotropic Drugs